A clinical study on the topical application of tranexamic acid + gelatin sponge in lumbar surgery
CHANG Lei
XIONG Wei
LIU Hong-zhe
LIU Xiang-yang
Abstract：Objective To study the topical application of tranexamic acid + gelatin sponge in lumbar surgery. Methods A total of 60 patients with lumbar surgery in our hospital were included from May 2014 to March 2015. All were randomly divided into 2 groups using random number table. Experimental group ( n = 30, tranexamic acid +gelatin sponge ): 15 males and 15 females; the average age ( 51.13 ± 6.20 ) years ( range: 25 - 71 years ); lumbar disc herniation in 21 cases ( 70.0% ), lumbar spinal stenosis in 4 cases ( 13.3% ), lumbar spondylolisthesis in 5 cases ( 16.7% ); 8 cases with hypertension, coronary heart disease and other medical diseases. Control group ( n = 30, gelatin sponge ): 13 males and 17 females; the average age ( 52.80 ± 6.30 ) years ( range: 24 - 78 years ); lumbar disc herniation in 19 cases ( 63.3% ), spinal stenosis in 3 cases ( 10.0% ), lumbar spondylolisthesis in 8 cases ( 26.7% ); 10 cases with hypertension, coronary heart disease and other medical diseases. Drainage volume of the first three eight hours, the total drainage, extubation time, preoperative and postoperative RBC HCT and Hb values at day 1, day 3, day 7 were compared between the 2 groups. Results ( 1 ) Compared with the control group, the drainage volume of the first eight hours of the experimental group was reduced ( 83.52 ± 60.78 ) ml vs. ( 169.38 ± 76.99 ) ml. Differences were statistically significant ( P < 0.05 ). Drainage volume of the experimental group was significantly lower than the control group. Drainage volume of the second and third eight hours was reduced, respectively ( 47.24 ± 40.67 ) vs. ( 54.93 ± 44.03 ) ml, ( 23.86 ± 26.01 ) vs. ( 33.21 ± 26.19 ) ml. Differences were not statistically significant ( P >0.05 ). ( 2 ) Comparing the three eight hours of the drainage volume between the 2 groups, the overall differences in the drainage volume of the first eight hours and the second or the third eight hours were statistically significant ( P <0.05 ). Drainage of the experimental group was more significant. Drainage volume of the second eight hours and the third eight hours was not statistically significant ( P > 0.05 ). ( 3 ) Total drainage volume ( 154.62 ± 97.74 ) ml vs. ( 257.86 ± 123.59 ) ml, with statistical significance ( P < 0.05 ). Total drainage volume of the control group was higher than that in the experimental group. ( 4 ) No statistical significance existed in the extubation time ( P > 0.05 ). The mean extubation time of the experimental group was shorter than the control group. ( 5 ) Hb and HCT values of the first day postoperatively, respectively ( 120.79 ± 14.96 ) g / L vs. ( 111.14 ± 19.64 ) g / L, ( 36.441 ± 4.345 ) % vs. ( 33.717 ± 5.075 ) %. Differences were statistically significant ( P < 0.05 ). Hb and HCT values in the experimental group were higher than the control group. No statistical significance existed in Hb and HCT values preoperatively and day 3, day 7 postoperatively ( P > 0.05 ). ( 6 ) Cerebrospinal fluid leakage occurred in 2 patients postoperatively. No other adverse reactions were observed. Conclusions Topical application of tranexamic acid + gelatin sponge in the lumbar surgery can significantly reduce the drainage volume with hemostatic effects. It is a safe and effective method to reduce bleeding amount with no adverse reactions.
Keywords：Tranexamic acidGelatin spongeabsorbableLumbar vertebraeSurgical proceduresoperative
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 786-791 )